LINDA WERTHEIMER, HOST:
No nation in the world has been more affected by HIV and AIDS than South Africa. But South Africa also had one of the most conflicted responses to the epidemic. A decade ago, as the virus was spreading rapidly, then-President Thabo Mbeki was questioning the link between HIV and AIDS. His health minister was advocating the use of beetroot, garlic and lemon juice to treat it. Now, years later, South Africa is trying to make up for lost time. The nation is attempting to put in place a cutting-edge HIV treatment and prevention program.
NPR's Jason Beaubien reports from the South African province with the highest rate of HIV.
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JASON BEAUBIEN, BYLINE: The lobby of the Municipal Health Clinic in Eshowe, in Northeast KwaZulu-Natal, is plastered with poster urging patients to get tested for HIV. It's in small clinics like this that you see the South African government's new commitment to battle the epidemic. While AIDS has been around for three decades, this clinic only started providing HIV drug treatment three years ago.
Futi Mlambo, a nurse at the clinic, says it started slowly in 2009.
FUTI MLAMBO: No, there was not a lot. There was not a lot for the beginning because, I think, for the first year we only had 20.
BEAUBIEN: But now she says they're putting roughly 20 people on treatment every week. The big change came last year when nurses, rather than just doctors, were allowed to place patients on drug therapy based on lab tests.
MLAMBO: If there's their - a CD4 is too low, they have to get the treatment immediately, they do that - whatever. Everything is being done here.
BEAUBIEN: In a country with almost 20 percent of the adult population infected with the virus, this shift in care from doctors to nurses is a major step in making treatment more accessible.
And nurse Mlambo says drug therapy has had remarkable effects.
MLAMBO: Even us, you know, once you see a person when he coming for testing, she can't even walk. And then, few months time, after starting the treatment, you find that he's well and walking around, no problem. You know, you feel that now, man, I've done something.
BEAUBIEN: She says the drugs are providing hope and encouraging even more people to get tested for HIV. But that hope could have been available years ago.
Eric Goemaere, with Doctors Without Borders, started the nation's first HIV drug treatment program in Cape Town 11 years ago.
DR. ERIC GOEMAERE: I think South Africa certainly lost at least 10 years pretending that actually HIV didn't cause AIDS, and that they could just not do anything significant.
BEAUBIEN: But now, the new minister of health, Aaron Motsoaledi, has vowed to completely eliminate HIV transmission from mothers to their babies. In 2010, Motsoaledi launched a massive testing program to try to get 15 million people tested. Goemaere says it's clear now that the leadership in South Africa wants to try to set up the best HIV prevention and treatment program in the world.
GOEMAERE: Trying to integrate all innovation, including treatment as prevention, into existing program. We pay, of course, we pay the 10 years lost with extremely high infection.
BEAUBIEN: Here in KwaZulu-Natal, nearly 30 percent of pregnant women are infected with HIV. At some government health clinics, half the women are HIV positive.
As the government has accepted the epidemic, so have many ordinary South Africans.
In the southern part of KwaZulu-Natal, Beauty Nkonyeni runs what she calls a Village for the Vulnerable. She feeds AIDS orphans. She takes in indigent elderly. She provides beds to people dying of various diseases. Ten years ago, people with AIDS were shunned, Nkonyeni, says and their neighbors often assumed that they were under a curse.
BEAUTY NKONYENI: People were dying in their homes. When they die, it was not HIV which was suspected. It was suspected that the person was bewitched by the neighbors, and so forth.
BEAUBIEN: Back then local residents didn't even want to feed them.
NKONYENI: They used to stay inside their room and they'd push their food because they don't want to get in contact with them.
BEAUBIEN: But that's changed now. She says as the government has shifted how it views HIV, so have most South Africans.
Jason Beaubien, NPR News, Durban.
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